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Capsule endoscopy: a cause of late small bowel obstruction and perforation

Anders Peter Skovsen1, Jakob Burcharth1, Stefan Kobbelgaard Burgdorf1

  • 1Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730 Herlev, Denmark.

Case Reports in Surgery
|January 7, 2014
PubMed

Insights

Capsule retention can cause serious complications like bowel obstruction, especially in Crohn's disease patients. A patency capsule test is recommended before capsule endoscopy if bowel stenosis is suspected.

Area of Science:

  • Gastroenterology
  • Digestive Endoscopy

Background:

  • Small bowel obstruction is a significant clinical challenge.
  • Capsule endoscopy is a valuable diagnostic tool but carries risks.
  • Crohn's disease is a known risk factor for intestinal stenosis.

Purpose of the Study:

  • To report a case of capsule retention leading to small bowel obstruction.
  • To highlight the importance of considering capsule retention in patients with suspected bowel stenosis.
  • To emphasize the utility of patency capsule testing.

Main Methods:

  • A case report detailing a patient with diffuse abdominal pain, vomiting, and weight loss.
  • Diagnostic workup included ultrasound, MRI, CT scan, and capsule endoscopy.
  • Surgical intervention (laparotomy) was performed, revealing perforation, stenosis, and impacted capsule.

Main Results:

  • A 71-year-old male patient experienced severe symptoms attributed to a retained capsule endoscope.
  • The capsule was found impacted in a stenotic segment of the small bowel, causing perforation.
  • Surgical resection and ileostomy were necessary, followed by successful ileostomy reversal.

Conclusions:

  • Capsule retention is a potential complication of capsule endoscopy, particularly in patients with Crohn's disease.
  • Suspected bowel stenosis warrants a patency capsule study prior to diagnostic capsule endoscopy.
  • Awareness and appropriate pre-procedural testing can prevent serious adverse events.

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